HVHS fully integrates retail clinics

Heritage Valley Health System has fully integrated retail medicine into its service line, a first in western Pennsylvania, which has become a test kitchen for new ways of delivering health care.

The Beaver-based hospital network opened it first ConvenientCare clinic in a Wal-Mart store in 2009 and has added four more store clinics since then, Dr. John Luellen, medical director of satellite services, said. HVHS has a medical staff of 425 doctors, about half of whom are system employees, and primary care doctors are encouraged to use the store clinics for patients who need attention for minor problems after hours.

Luellen moderated a panel discussion Wednesday at Robert Morris University, which looked at the role of nurses with doctorate degrees in the health care delivery system. RMU has offered the advanced degree since 2007 and experts say the role for so-called physician extenders is increasing rapidly.

HVHS's integration efforts have succeeded, Luellen said.

“It seems to be working very well,” he said. “The backbone of all this is the information technology system.”

HVHS leases space in stores for the clinics and electronically links them to the hospital network’s electronic medical records. That means the nurse practitioners staffing the store clinics have immediate access to medical records for most patients, Luellen said.

Retail clinics and urgent care centers can provide many of the same services of a hospital emergency room at a fraction of the cost, making the clinics an attractive option at a time of belt tightening in health care, said RMU health care economist Stephen Foreman.

“There is incredible demand already,” Foreman said. “There isn’t enough money to do what we’re doing in health care for a long time.”

Unlike urgent care centers, where some 40 percent of patients do not have a primary care doctor, Luellen said most ConvenientCare patients already have a family doctor. The integration of retail medicine also positions HVHS to become part of an accountable care organization, a new way of paying doctors and hospitals, which is expected to replace the traditional fee-for-service arrangement.

Like in-store clinics, Morgantown-based MedExpress Urgent Care has targeted the high cost of care of hospital emergency rooms by opening 21 clinics in western Pennsylvania in recent years. In an interview on Monday, MedExpress President and CEO Dr. Frank Alderman said the chain was succeeding in reducing the overall cost of health care while providing quality care and a pleasant patient experience.

“We have to stop the thinking that there’s only a primary care office and emergency room,” Alderman said. “There’s more than the rotary dial and a party line.

“We can take billions of cost out of the system, and we’re going to do that.”

(A full interview with Dr. Frank Alderman appears in the Oct. 7 print and online editions of the Pittsburgh Business Times.)